After you have had your baby

This can start from day 3 and can last for up to 2 weeks. 

What does this look like?

• Feeling emotional, irrational or irritable
• Bursting into tears for no known reason 
• Feeling depressed or anxious 

These symptoms can be normal.

Things that will help: 

• Get plenty of rest 
• Limit visitors and trips out 
• Eat well
• Sleep/nap when your baby does

If baby blues don’t seem to be going away after 2 weeks, or you are feeling concerned about your mental wellbeing, speak to your Midwife, Health Visitor or GP.

The baby blues are not an illness and should settle without any treatment.

This affects 1 in 10 women and birthing people; occurs 2-8 weeks after birth and lasts longer than 2 weeks. It is an illness.

Symptoms include:

• Anxiety in general, or worrying a lot about your baby
• Feelings of not being able to cope 
• Panic attacks 
• Struggling to sleep 
• Not able to stop crying 
• Extreme tiredness 
• Loss of appetite 
• Aches and pains 
• Feelings of hopelessness 
• Feeling generally unwell
• Not being able to enjoy things you normally would
• Unable to concentrate
• Memory loss
• Loss of interest in your baby 

Ask your Midwife about local support groups. Speak to your GP about your symptoms as it is easily treated with talking therapies and/or medicines.

Puerperal psychosis is an emergency and needs urgent referral to a specialist, please contact your GP or speak to your midwife so they can get you the support you need if you have any of the following symptoms: 

• new feelings and thoughts which you’ve never had before
• new thoughts of violent self harm
• sudden start of or rapidly worsening mental symptoms
• persistent feelings of estrangement from your baby (less affectionate)

A Deep Vein Thrombosis (DVT) is a blood clot that often forms in the veins of the lower leg or calf. The blood clot may break away and travel to your lungs (Pulmonary Embolus (PE)) or your brain and this is very dangerous.

Risk factors include:

• surgery
• previous DVT 
• being overweight 
• dehydration
• smoking
• not moving around much 
• blood disorders 
• some contraceptives 
• pregnancy and birth 
• being over the age of 35

Help reduce your risk by:

• keeping mobile (moving around)
• drinking plenty and keep hydrated 
• moving your ankles around if you are not moving much

If you have a few risk factors, further treatment may include:

• blood thinning injections 
• anti-embolic (compression) stockings 

Signs of a DVT/PE require urgent medical attention. See your GP or attend A&E if you have any of the following symptoms:

• calf pain (one-sided), any redness or swelling 
• shortness of breath 
• pain in your chest or upper back 

This can continue for a number of weeks after childbirth. 

• Expect a bright red, heavy flow for the first few days. This then tapers off and becomes dark red, brown, watery pink, yellow then white
• Gently increase activity 

Contact your GP or Midwife if: 

• you have heavy vaginal bleeding 
• your discharge has an unpleasant smell 
• you have a temperature over 38oC (100.4F)
• you have shivering or flu like symptoms 

What should I do if I pass any clots? 

It can be normal to pass small clots. Clots should be no bigger than a 50 pence coin.

Check your loss is normal (smaller than a 50p coin). If normal, carry on as usual.

If the clots are larger than a 50p coin, please contact your Midwife as soon as possible.

If you have heavy blood loss, rest, and if bleeding continues contact your GP or Midwife.

Hygiene is really important.

• Wash your hands before and after changing pads 
• Change sanitary pads frequently. Maternity pads are best for first few days then change to lighter pads. Avoid the use of tampons as these can cause infection
• Bathe or shower daily 
• Use plain water for washing around your vagina / perineum for the first few days. Avoid scented products as they may cause irritation
• Avoid using salt

Vaginal soreness is normal. 

What can help? 

• Use a cold compress which you can buy from the internet or in shops only use for no more than 30 minutes at a time, with a break of at least an hour in first couple of days
• Lavender oil can be used in the bath to help with healing. Use by dissolving 3 drops in your bathwater before bathing. If you find the oil sits on the surface of the bath water, adding the 3 drops to a small amount (about an eggcup full) of full fat milk before putting it in the bath helps it to dissolve evenly. 
• Use painkillers such as paracetamol. Speak with you Midwife or GP if you are unsure of the correct dose. 
• Remember to do pelvic floor exercises regularly 

Rotherham Hospital Perineal clinic 

• Open alternate Tuesdays, 9am to 5pm 
• Your GP or a Midwife can refer you 
• Call Greenoaks for an appointment on 01709 424513

Contact your GP or Midwife if:

• your perineum becomes extremely painful 
• you have any signs of infection

Signs of infection include: 

• redness around the wound
• skin around the wound being warm to touch
• swelling around the wound
• weeping around the wound
• gaping around the wound
• having a fever, shivering or a high temperature (more than 38oC).
• needing stronger pain relief

Triage (01709 427700) or 111 should be contacted through the night.

Additional information for care of your perineum

• Avoid the use of ‘donut’ rings
• Try to wear loose clothing (no tight jeans or ‘thongs’) 
• Rest lying down when able, this can relieve the pressure from your  perineum 
• Expose your perineum to air after drying after a bath or shower
• You can buy over the counter pain relief such as paracetamol and ibuprofen if needed after hospital prescription medicines run out.

• Keep your wound clean and dry 
• Bathe or shower daily
• Use a separate cloth/wash puff for your wound 
• Dry well and lift tummy up and air if needed 
• Wash hands before and after changing pads

Pelvic floor exercises strengthen the muscles around your bladder, vagina and back passage. This can help to stop incontinence, treat prolapse and make sex better too.

• You can do this exercise lying down, sitting or standing 
• With practice, it can be done anywhere and at any time 
• Squeeze and draw in your back passage as if you’re holding in wind
• Squeeze around your vagina and urethra (tube from your bladder) as if you’re stopping the flow of urine 
• Now relax. This is a short squeeze. Rest for a second, then repeat these squeezes until you feel the muscles get tired.
• After a short rest, squeeze again as above. This time hold the squeeze for as long as you can (but not for more than 10 seconds), then relax 
• It’s important to keep breathing normally while you do these exercises. 
• Make sure you don’t pull in your stomach or squeeze your buttocks when you squeeze
• Aim to build up to 10 repeats of each exercise, four to six times a day

In the past, it was taught to practice these squeezes while urinating (having a wee). This isn’t the best way to do these exercises because you may not empty your bladder completely.

Get contraception in place before you need it.

• Contraception is free on the NHS
• Contraception can be arranged by contacting your GP or the Sexual Health Service at Rotherham Hospital on Level C opposite the Chapel. 
• For an appointment at the Sexual Health Service please telephone 01709 427777 
• There are 13 different types of contraception. Some can start 3 weeks after birth 
• Choose a type that suits you 
• Breastfeeding is not a form of contraception 
• Resume sexual relations when you feel comfortable

Additional information

• Take time to enjoy your new baby. They need your love and attention
• Your body needs to recover after birth 
• Sexual intercourse after birth may not be comfortable. If it is painful, stop and try again at a later date
• If problems persist contact your GP or the Sexual Health Service on 01709 427777  

It is important that any medication prescribed and given to you is taken correctly and the course is completed. 

The following 3 medications need to be completed to avoid complications:

1. Antibiotics - these are given to you if you have any infection.
2. Antihypertensives - these are given to you if you have been diagnosed with high blood pressure.
3. Blood thinning injections known as Tinzaparin - these are given to prevent blood clots in your brain, lungs and legs, which can be very dangerous or even fatal.

• You will be shown how to give the injection before you go home. Either yourself or a family member can do this.      
• You will also be given Thrombo-Embolic Deterrent (TED) stockings to wear for as long as you are on Tinzaparin. We give you a spare pair to go home with
• You will go home with a sharps bin and instructions on its collection from Rotherham Borough Council

See your GP or Midwife today if you have:

• A fever, are shivering, have abdominal pain or smelly vaginal discharge
• Calf pain (one-sided), any redness or swelling 
• Headaches with nausea, vomiting or visual disturbances within the first few days
• Faintness, dizzyness or palpitations 
• Puerperal psychosis 

Call 999 if you have:

• shortness of breath or chest pain 
• sudden or extreme blood loss 
• a sudden collapse 
• severe headache 

Additional information

• If you are unable to contact your GP or Midwife for a priority appointment the same day, use your out of hours GP service or attend your nearest Urgent and Emergency Care Centre or Accident and Emergency
• If you are unable to be seen within the next 4 hours contact Wharncliffe ward for advice on 01709 424348

Jaundice causes the baby’s whites of their eyes and sometimes their skin to become yellow. This is due to a breakdown of excess red blood cells that the baby does not need. However, sometimes the visual signs of jaundice are not obvious, particularly for premature or newborn babies with brown or black skin. 

• Babies under 24 hours old becoming jaundiced will require urgent medical attention
• Jaundice is common in newborn babies over 24 hrs old 
• Babies over 24 hours old should be reviewed by Midwifery staff the same day 
• It is important that babies with jaundice feed often

Additional information on jaundice

• Midwifery staff assess babies for jaundice at each visit 
• Any baby with jaundice over 24 hours old will have their level of jaundice checked with a machine. If the reading is high, baby will need a review in hospital by a paediatrician (Doctor specialising in children).
• We encourage you to feed your baby often
• Feed your baby when they wake for feeds. In the first few days some babies may need to be woken for feeds. 
• Feeding flushes out the bilirubin (from the breakdown of red blood cells that baby no longer needs). Bilirubin is passed out of the body in wee and poo
• If bilirubin is left to build up, it can cause your baby to become sleepy and your baby could become ill
• If you are concerned about your babies colour, poor feeding or if you think they are sleeping too much, please contact your Midwife 
   

The safest place for your baby to sleep is in their own crib or cot 

• Sleep with your baby in the same room as yourself (both day and night) for 6 months 
• Always place your baby on their back to sleep 
• Place baby’s feet at the foot of the crib or cot 
• Use a firm, flat well fitting, waterproof mattress 
• Do not use duvets, bumper sets or pillows 
• Keep your baby’s face and head uncovered 
• Avoid your baby overheating 
• Keep your baby’s environment smoke free 
• Never sleep with your baby on a sofa or armchair 

At home the Midwife or Midwifery Support Worker will undertake a safe sleeping assessment and will ask to be shown where your baby will be sleeping during the day and at night. This is only to offer guidance on the safest way for your baby to sleep.

Further checks may be needed if any risks are identified. These may be carried out by your Health Visitor or Midwife.

The Lullaby Trust has more information about safe sleeping.

• Baby is settled during and after feeds 
• They appear healthy and alert when they’re awake 
• In the first 48 hours, your baby is likely to have two or three wet nappies
• From day five onwards, wet nappies should start to become more frequent, with at least six heavy, wet nappies every 24 hours 
• From the day five breast fed babies should have at least two soft yellow poos the size of a £2 coin, every day for the first few weeks
• From the day five formula feeding babies should pass soft yellow poos which should remain soft and may vary in frequency 
• Your baby gains weight steadily after the first two weeks. It’s normal for babies to lose some of their birth weight in the first two weeks. 

Additional information

• If you choose to breastfeed you will receive information and support on how to position and attach baby to your breast, to always offer the second breast, to feed 8 to 12 times in 24 hours, how to express breast milk and about responsive feeding
• If you choose to formula feed you will receive information and support on how to make up feeds, what type of formula to use, how to feed baby and responsive feeding
• All babies are weighed on day 3 and day 5 after birth and again a few days later before being discharged from Midwifery services 
• Babies are usually weighed on a monthly basis after they have gained their birth weight (this happens more frequently if a problem is found).

Why do babies cry?

Babies can cry because they:

• are hungry 
• are tired
• feel uncomfortable and need winding 
• are overstimulated or bored l   Because they feel unwell 
• have a wet or dirty nappy 
• need a cuddle 
• are too hot or too cold 
• are in pain 

How do I calm my baby?

• Feed your baby
• Hold your baby close (skin to skin is best) 
• Gently sway or dance with your baby 
• Talk or sing to your baby 
• Bathe your baby (or with them)
• Use motion by gently rocking your baby in your arms, their pushchair, or go for a walk or drive
• Turn the radio on and lights on (during day) 
• Take turns with your partner or someone else to settle your baby 
• Seek information about infant massage classes

Additional information on calming a crying baby

• Babies are able to sense their parent’s anxiousness, therefore your partner, friend or family member may be able to settle your baby if you are stressed
• If you want to settle your baby through the night, keep lights low and sounds quiet so baby learns the difference between day and night
• Babies are often unsettled in the evenings
• If colic is going to develop, this usually starts within the first few weeks and stops around 4 months

By law all children under the age of 12 or 135cms (whichever comes first) must travel in the correct child car seat even for short journeys.

• Use a rear facing car seat up until the child reaches 15 months, after this time a forward facing seat can be used
• Only use EU approved height based seats 
• Make sure the seat is fitted properly in the car following the manufacturer’s instructions
• Use the back seats for all children under five if you can 
• Never leave your baby or toddler alone in the car 
• The safest place for a baby seat is behind the driver 
• It is dangerous and illegal to carry a baby in a rear-facing baby seat in a front car seat that has an active airbag.

Symptoms your baby may have that need urgent medical attention

Babies feed frequently. The first sign of an unwell baby is a baby who will not wake for feeds or refuses to feed.

Rashes in babies are very common and come and go. If the rash persists or a rash is noted and baby is unwell seek medical advice.

See your GP or Midwife today if your baby:

• has a high pitched continuous cry
• starts to refuse feeds
• seems more sleepy or is not waking for feeds 
• has reduced wet nappies 
• vomits (is sick) green bile 
• passes blood in their poo
• has thrush - sore buttocks or white coating on their tongue which does not clear (usually found in bottle-fed babies or with dummy use) 

Call 999 if your baby:

• is floppy, unresponsive or has glazed eyes 
• stops breathing 
• turns blue, mottled or very pale 
• has a fit (febrile convulsion) 
• has a high temperature (over 38˚C) 
• has difficulty breathing, is breathing fast or is grunting whilst breathing. If their belly is sucking in under their ribs when breathing they are having breathing difficulties
• has a spotty purple, red rash anywhere on their body 

You need to book an appointment at Riverside House, open Monday to Friday. 

You can either phone for appointment on 01709 823543 or book online through Rotherham Council's website.  

You will need to take baby’s red book as well as other documentation – please see the Council's website for details. 

Additional information

• Child benefit forms can be found in the Bounty Pack 
• Child tax credit office contact details: online or telephone 0345 300 3900 
• Healthy Start Vouchers: Complete the form found in the booklet (See leaflet for inclusion criteria)
• A Community Midwife will visit the day after your discharge from hospital (9am to 5pm). If they have not attended by 4pm, call 01709 424348 
• A Health Visitor will see you at home from 10 days after the birth of your baby.

Wharncliffe Ward

01709 424348 

Labour Ward

01709 424491 

Midwifery Triage

7am to 7pm 
01709 427700

Greenoaks

Monday to Friday, 9am to 5pm 
01709 424513 

Sexual Health Services

Monday to Thursday, 8.30am to 7.30pm, Friday, 9am to 5pm and Saturday, 10am to 2pm
01709 427777 

Community Midwifery Office

Monday to Friday, 9am to 4pm
01709 424058

Birth in Mind

01709 427123
Email: rgh-tr.birthinmindservice@nhs.net 

The service is offered to people who would like to talk to someone about any unanswered questions or unresolved feelings following their experiences within our speciality. 

Please note: This is often a voicemail inbox which is regularly checked. You should receive a call back within 3 weeks of your call.